DO YOUR BEST! “A creative man is motivated by the desire to achieve, not by the desire to beat...

DO YOUR BEST!

“A creative man is motivated by the desire to achieve, not by the desire

to beat others.”-Ayn Rand

PANSYTEMIC DISEASES

These diseases are covered predominantly in chapter 9 of your textbook

CASE #1

PATIENT PRESENTATION

• SIGNALMENT: 12 week old, male/neutered, mixed breed puppy

• PRESENTING COMPLAINT: lethargy, ocular and nasal discharge for the past 3 days; mild cough, appetite is poor; puppy had diarrhea last night and vomiting/diarrhea this morning– Diet: Science diet puppy dry

• Hx: puppy adopted from local shelter 2 weeks ago; has received one set of vaccinations – owner was planning to schedule booster shots in one week


• Hx: Puppy received his first doses of Heartworm and flea prevention 2 weeks ago at time of adoption.

• Other Info: Client has 1 other dog who is 1 year old and fully vaccinated; and 2 cats who are 2 and 5 yrs old that are fully vaccinated


• PHYSICAL EXAM FINDINGS:– Lethargy– ~8% dehydrated– Temp: 103.8, HR: 116, RR: 20 – lung fields sound

slightly moist, and the puppy coughs a few times during the exam

– Mm: pink, CRT: 2.5sec– Mucopurulent ocular/nasal discharge– The nose looks, dry, thick, and crusty



ENAMEL HYPOPLASIA

HYPERKERATOSIS OF NOSE & FOOT PADS

• DIAGNOSTIC TEST RESULTS:CBC shows:– Leukopenia –early in the disease– Mild anemia

• WORSENING OF CLINICAL SIGNS: 1 week later, the client returns. The puppy is weak and appears to have muscle twitching; muscle of the mouth appear as if the puppy is “chewing gum”; there are pustules on the abdomen, and hyperkeratotic foot pads

DIAGNOSTICS AND TREATMENT

• TREATMENT– ANTIBIOTICS– FLUIDS– SYMPTOMATIC TREATMENT• Anti-emetics• Ophthalmic ointments• Cleaning ocular/nasal discharge frequently• Nutrition• Clean, dry environment; low stress

• DIAGNOSTICS– Blood work is drawn for a CBC, serum chemistry

profile and Canine Distemper titers


DIAGNOSIS:CANINE DISTEMPER VIRUS

http://www.youtube.com/watch?v=QL4S4MA2zT0

http://www.youtube.com/watch?v=HyEFS77rOzU

*Myoclonus is characteristic for Canine Distemper







• FURTHER DIAGNOSTICS:– Blood work drawn to compare paired serum titers and CBC

results; Flourescent antibody(FA)• CBC: Leukocytosis with neutrophilia found due to

secondary infection

• FA: Viral inclusions are found in mononuclear cells of the blood smear– Post-mortem tissue sample taken from mucous membranes

or epithelial cells of the urinary, respiratory, or GI tract may also display viral inclusions.

• Titers have increased since last measurement


• Transmission of this (single-stranded, RNA, paramyxo-) virus is through aerosolization of bodily fluids, fomites

• Fatality rate may be as high as 90%• Prognosis is guarded at best, especially if neurologic signs are

present• Neurologic signs may be focal to general including seizures

– Could occur weeks to years after initial infection

• Although Distemper is contagious, it is unlikely to affect the clients older, vaccinated dogs– CVD does not affect cats

PROGNOSIS & CLIENT INFORMATION

• Vaccination• Thorough cleaning – the virus is labile and can

be killed with common disinfectants, and heat• Isolation of infected animals

PREVENTION

CASE #2

• SIGNALMENT: 4yr old, female spayed, daschund

• PRESENTING COMPLAINT: dry, hacking cough; dog is still active and eating and drinking well. Coughing began about 1 week ago.

• Hx: Owner began sending the dog to day care everyday while she was at work; After the puppy set of vaccines, dog was vx at 1yr and 2 yrs old. She received an injectable Bordetella vaccine 1 day before beginning daycare.


• Hx: – Diet: Purina One– Patient is current on HW and flea prevention– No other significant illnesses– HW negative

• PHYSICAL EXAM FINDINGS:– Temp: 102.1, HR: 140, RR: 36– Sneezing and occasional coughing on exam

• Cough can be ellicited on tracheal palpation• Mild, clear nasal discharge

– Normal hydration status– Mm: pk CRT: <2sec


• Aka Infections Tracheobronchitis• Major causes– VIRUSES: Canine Adenovirus-2, Parainfluenza,

Canine herpesvirus, Canine Influenza, canine distemper virus

– BACTERIA: mycoplasma, bordetella bronchiseptica, streptococcus sp.

DIAGNOSIS: CANINE RESPIRATORY DISEASE COMPLEX

http://www.youtube.com/watch?v=amGKQX9zdug



• DIAGNOSTICS– Based on physical exam, clinical signs and history

– Virus isolation from swabs of the pharynx, nasal passageways, trachea

– Thoracic rads if pneumonia suspected

DIAGNOSTICS & TREATMENT

• TREATMENT– Adequate hydration– Antibiotics– Antitussives• Hycodan (hydrocodone)• Butorphanol• Cough Tabs (dextromethorphan, guafenesin)• Bronchial dilators

– Aminophylline– terbutaline

DIAGNOSTICS & TREATMENT

• Transmission of these organisms is by inhalation of respiratory droplets or contact with fomites

• The prognosis is good with proper treatment– It is a self-limiting disease– May take 2-3 weeks to resolve

• Vaccinate 2-3 weeks prior to expected exposure when using the injectable vaccine– If using the intranasal vaccine 2-3 days prior to exposure is

recommended


• Isolate infected animals• Vaccinate appropriately• Most routine disinfectants, bleach,

quarternary ammonium compounds will kill these viruses and bacteria

• Proper sanitation

PREVENTION

CASE #3

• SIGNALMENT: 3mth old Rottweiler puppy, intact male

• PRESENTING COMPLAINT: lethargy, poor appetite, bloody diarrhea for 2 days; puppy has vomited twice this morning

• Hx: Owner purchased puppy from local trader’s market at 10 weeks old. The breeder gave the first set of vaccinations at 3 weeks old and a booster @ 7 weeks


• Hx: owner already has a 6mth old, intact female Rottweiler he got as a gift from a family member. He purchased the new puppy as a playmate.– The 6mth old puppy had 3 sets of vaccinations

given by the family member.– Neither puppy has been started on heartworm or

flea prevention.– Diet: Blue Buffalo


• PHYSICAL EXAM FINDINGS:– ~8% dehydrated• Mm:pale, CRT: >2.5sec

– Depressed– Rear soiled in blood-tinged diarrhea, strong, foul

odor– Temp: 103.5, HR: 120 RR: 24


• Fecal• Parvo ELISA (snap test)– Detects viral antigen

• CBC/Serum Chemistries– Marked lymphopenia, neutropenia, increased PCV– Hypoglycemia, hypokalemia

• Parvo titers– High titers (1:10,000)

DIAGNOSTICS

PARVO ELISA

PATHOGENESIS

• TRANSMISSION: fecal-oral route– Virus has affinity for rapidly dividing cells such as

intestinal epithelium & bone marrow; severe cases affect the myocardium (esp in utero)• Affect on bone marrow lymphopenia,

neutropenia WBCs may be <2000

– Possible sequelae: septicemia, intussusception

• ISOLATE INFECTED ANIMALS• HOSPITALIZATION– IV fluids w/added electrolytes, added dextrose– ANTIBIOTICS– ANTI-EMETICS

• Reglan• Maropitant (cerenia)• Ondansetron

– NSAIDs– +/- Plasma transfusion for hypoproteinemia– +/-ANTIVIRAL

• Tamiflu

TREATMENT

• PROGNOSIS: generally good with aggressive and early treatment; 80%-90% success– Concurrent infections and GI parasites can worsen

prognosis

PROGNOSIS

• VACCINATION– Keep puppies isolated until they have firm immunity,

usually about 18-22 weeks of age– Vaccinate at 6-8 weeks then q3-4 weeks until 16

weeks of age

• CLIENT INFO– In this case, the 1st 2 vaccines are not valid– Client should isolate the new puppy from the older

one– Treatment is expensive– The virus is resistant in the environment and may

survive for years. A 1:30 solution of bleach is effective.

PREVENTION & CLIENT INFORMATION

CASE #4

• SIGNALMENT: ~6 week old intact, male kitten, DSH

• PRESENTING COMPLAINT: mucopurulent ocular/nasal discharge, congestion, head shaking, sneezing, inappetance – has gotten progressively worse in the last week

• Hx: owner has been feeding a family of stray cats outside her home. Several of the kittens look like this. This is the only kitten she could catch


• Hx: no known vaccinations, no flea or HW prevention– Diet: owner feeds canned Whiskas

• PHYSICAL EXAM– Patient is QAR– Temp: 104.1, HR: 200, RR:40– Audible upper respiratory congestion– ~6-8% dehydrated– Mm: pale pk, CRT: 2 sec


• DIAGNOSTICS– Clinical signs– Nasal, pharyngeal swabs

• DIAGNOSIS:– Feline Viral Rhinotracheitis(FVR)

• Feline Herpesvirus-1– Feline Calicivirus (FCV)

• 80-90% of all URI is cause by 1 of these 2 viruses

Chlamydophila felis– Bordetella– Mycoplasma

DIAGNOSTICS

DIAGNOSIS

• FLUIDS• ANTIBIOTICS• NURSING CARE– Warm, clean– Force feed, warm, food– Pain meds for oral or corneal ulcers

• DECREASE STRESS• AVOID STEROID• ANTIVIRAL– Idoxuridine

TREATMENT

• Both FVR and FCV are highly contagious– Transmitted via fomites (hands, clothes) and

aerolsolization of respiratory droplets withing 5 feet

• Morbidity is high, mortality is low– Oral ulcers can last 7-10 days


• VACCINATION– Vaccines will reduce severity and duration of

clinical signs

• Isolate infected animals

PREVENTION

DO YOUR BEST! “A creative man is motivated by the desire to achieve, not by the desire to beat...

Documents

Transcript of DO YOUR BEST! “A creative man is motivated by the desire to achieve, not by the desire to beat...